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Is the patient trying to tell me something?

Key history

Clarify the exact nature of the presenting complaint: what the patient means by ‘indigestion’ or ‘heartburn’. Note the relationship of the symptoms to eating. In particular, care should be taken to consider and perhaps exclude ischaemic heart disease. Analyse the presenting symptom according to site and radiation, character of discomfort, aggravating and relieving factors and associated symptoms. Drug history and past history is important, especially NSAID use.